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01.12.2014 | Research article | Ausgabe 1/2014 Open Access

BMC Anesthesiology 1/2014

Nasal high–flow oxygen therapy in patients with hypoxic respiratory failure: effect on functional and subjective respiratory parameters compared to conventional oxygen therapy and non-invasive ventilation (NIV)

Zeitschrift:
BMC Anesthesiology > Ausgabe 1/2014
Autoren:
Norbert Schwabbauer, Björn Berg, Gunnar Blumenstock, Michael Haap, Jürgen Hetzel, Reimer Riessen
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1186/​1471-2253-14-66) contains supplementary material, which is available to authorized users.

Competing interests

Fisher & Paykl provided two Optiflow-devices at no charge for the study. Otherwise the investigators received no financial support for the study and the company was not involved in data analysis and publication of the study.

Authors’ contributions

NS. Conception and design of the study, data acquisition, data analysis, manuscript drafting BB. Conception and design of the study, data acquisition, data analysis, manuscript editing GB. Conception and design of the study, data analysis, statistics, manuscript editing MH. Recruitement of subjects for the study, data acquisition, manuscript drafting, manuscript editing JH. Conception and design of the study, data analysis, manuscript editing RR. Conception and design of the study, recruitement of subjects, data analysis, manuscript editing. All authors read and approved the final manuscript.

Abstract

Background

Aim of the study was to compare the short-term effects of oxygen therapy via a high-flow nasal cannula (HFNC) on functional and subjective respiratory parameters in patients with acute hypoxic respiratory failure in comparison to non-invasive ventilation (NIV) and standard treatment via a Venturi mask.

Methods

Fourteen patients with acute hypoxic respiratory failure were treated with HFNC (FiO2 0.6, gas flow 55 l/min), NIV (FiO2 0.6, PEEP 5 cm H2O Hg, tidal volume 6–8 ml/kg ideal body weight,) and Venturi mask (FiO2 0.6, oxygen flow 15 l/min,) in a randomized order for 30 min each. Data collection included objective respiratory and circulatory parameters as well as a subjective rating of dyspnea and discomfort by the patients on a 10-point scale. In a final interview, all three methods were comparatively evaluated by each patient using a scale from 1 (=very good) to 6 (=failed) and the patients were asked to choose one method for further treatment.

Results

PaO2 was highest under NIV (129 ± 38 mmHg) compared to HFNC (101 ± 34 mmHg, p <0.01 vs. NIV) and VM (85 ± 21 mmHg, p <0.001 vs. NIV, p <0.01 vs. HFNC, ANOVA). All other functional parameters showed no relevant differences. In contrast, dyspnea was significantly better using a HFNC (2.9 ± 2.1, 10-point Borg scale) compared to NIV (5.0 ± 3.3, p <0.05), whereas dyspnea rating under HFNC and VM (3.3 ± 2.3) was not significantly different. A similar pattern was found when patients rated their overall discomfort on the 10 point scale: HFNC 2.7 ± 1.8, VM 3.1 ± 2.8 (ns vs. HFNC), NIV 5.4 ± 3.1 (p <0.05 vs. HFNC). In the final evaluation patients gave the best ratings to HFNC 2.3 ± 1.4, followed by VM 3.2 ± 1.7 (ns vs. HFNC) and NIV 4.5 ± 1.7 (p <0.01 vs. HFNC and p <0.05 vs. VM). For further treatment 10 patients chose HFNC, three VM and one NIV.

Conclusions

In hypoxic respiratory failure HFNC offers a good balance between oxygenation and comfort compared to NIV and Venturi mask and seems to be well tolerated by patients.

Trial registration

German clinical trials register: DRKS00005132.
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